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The enhancement of jet engine components may result in the expansion of the established design space. In particular, the trend towards short and therefore highly aggressive inter compressor ducts (ICD) extends the traditional design space. The potential for fuel savings resulting from a reduction in engine weight is in contrast to the emergence of a more complex flow field. Many studies consider the secondary flow system of highly aggressive ICDs at the design point, but there is a lack of off-design considerations. To fill this gap, the present study investigates in detail the off-design performance of the new German Aerospace Center (DLR) test case. Firstly, computational fluid dynamics (CFD) simulations of different typical operating points allow detailed considerations of the flow field under off-design conditions. Secondly, a variation of the inlet conditions describes the sensitivity of highly aggressive ICDs to different low-pressure compressor operating points. Finally, the comparison of the CFD stagnation pressure loss with the loss predicted by a preliminary off-design method validates the use of traditional off-design prediction during the preliminary design of highly aggressive ICDs.
The stratigraphic record of the Early Holocene in the Nebraska Sand Hills suggests dry climatic conditions and periods of sustained aeolian activity, which resulted in several well-documented instances of sand dunes blocking river drainages in the western Sand Hills. Here, we present evidence that drainage blockage by migrating sand dunes also occurred in the central Sand Hills, where precipitation is higher and dune morphology differs. The South Fork Dismal River valley contains a sequence of aeolian, alluvial, and lacustrine sediments that record a gradual rise of the local water table following a sand dune blockage of the river valley around 11,000 years ago. After the initial development of a wetland, a lake formed and persisted for at least 2000 years. Increased groundwater discharge due to a warm, moist climate in the region after 6500 years ago likely caused the breaching of the dune dam and eventually resulted in the decline of the local water table. Through a careful examination of the intricate relationships between ground water, surface water, and sand movement in a dune field setting, we discuss the hydrologic system's complex response to climate change. We use diatoms to reconstruct the lacustrine environment and optically stimulated luminescence and radiocarbon dating to provide chronological control, based on a careful evaluation of the strengths and limitations of each method in varied depositional environments.
This study aimed to review and synthesize the need estimates for psychiatric beds, explore how they changed over time and compare them against the prevalence of actually existing beds. We searched PubMed, Embase classic and Embase, PsycINFO and PsycIndex, Open Grey, Google Scholar, Global Health EBSCO and Proquest Dissertations, from inception to September 13, 2022. Publications providing estimates for the required number of psychiatric inpatient beds were included. Need estimates, length of stay, and year of the estimate were extracted. Need estimates were synthesized using medians and interquartile ranges (IQRs). We also computed prevalence ratios of the need estimates and the existing bed capacities at the same time and place. Sixty-five publications with 98 estimates were identified. Estimates for bed needs were trending lower until 2000, after which they stabilized. The twenty-six most recent estimates after 2000 were submitted to data synthesis (n = 15 for beds with unspecified length of stay, n = 7 for short-stay, and n = 4 for long-stay beds). Median estimates per 100 000 population were 47 (IQR: 39 to 50) beds with unspecified length of stay, 28 (IQR: 23 to 31) beds for short-stay, and 10 (IQR: 8 to 11) for long-stay beds. The median prevalence ratio of need estimates and the actual bed prevalence was 1.8 (IQR: 1.3 to 2.3) from 2000 onwards. Historically, the need estimates for psychiatric beds have decreased until about 2000. In the past two decades, they were stable over time and consistently higher than the actual bed numbers provided.
Clays are involved in a variety of natural and managed processes, and calculation of their stability conditions is important. Such calculations are still fraught with large uncertainties owing to the lack of experimental constraints on the thermodynamic properties of clays, and bracketing of equilibrium reactions at low temperature is barely possible. Experiments aimed at studying the thermal stabilities of, and composition-temperature relations among, smectite, illite, kaolinite, pyrophyllite, mica, and chlorite at different levels of SiO2, K2O, MgO, and Al2O3 species in solution were conducted under a strong thermal gradient in the simple K2O-Al2O3-SiO2-H2O (KASH), MgO-Al2O3-SiO2-H2O (MASH), and KMASH systems. The crystallization series observed in the different experiments match to some degree those observed in active geothermal systems where clay minerals precipitate from oversaturated solutions. Smectite and/or ordered mixed-layer materials, smectite-donbassite, or possibly pyrophyllite-donbassite were observed to crystallize in both KASH and MASH experiments. Similar crystallization sequences and clay composition variations with temperature were observed in most cases when the relative positions of the starting solids were switched. The experimental results were used to refine the thermodynamic properties of K- and Mg-smectite. Stability diagrams calculated by energy minimization and activityactivity diagrams are consistent with the experimental mineral variations, suggesting that smectite is thermodynamically stable at temperatures as high as 300°C in the presence of diluted water and quartz and K-feldspar-free systems.
Dental and mucosal injuries from laryngoscopy in the peri-operative period are common medico-legal complaints. This study investigated lawsuits arising from laryngoscopy.
Methods
Westlaw, a legal database containing trial records from across the USA, was retrospectively reviewed. Plaintiff and/or defendant characteristics, claimed injuries, legal outcomes and awards were extracted.
Results
Of all laryngoscopy-related dental or mucosal injuries brought before a state or federal court, none (0 per cent) resulted in a defence verdict against the provider or monetary gain for the patient. Rulings in the patient's favour were observed only when laryngoscopy was found to be the proximate cause of multiple compounding complications that culminated in severe medical outcomes such as exsanguination, septic shock or cardiopulmonary arrest.
Conclusion
Proper laryngoscopy technique and a robust informed-consent process that accurately sets patients' expectations reduces litigation risk. Future litigation pursuits should consider the low likelihood of malpractice allegation success at trial.
To reduce Coronavirus Disease 2019 (COVID-19)-related mortality and morbidity, widely available oral COVID-19 treatments are urgently needed. Certain antidepressants, such as fluvoxamine or fluoxetine, may be beneficial against COVID-19.
Objectives
The main objective was two-fold: (i) to test the hypothesis that the prevalence of antidepressant use in patients hospitalized with COVID-19 would be lower than in patients with similar characteristics hospitalized without COVID-19, and (ii) to examine, among patients hospitalized with COVID-19, whether antidepressant use is associated with reduced 28-day mortality. Our secondary aim was to examine whether this potential association could only concern specific antidepressant classes or molecules, is dose-dependent, and/or only observed beyond a certain dose threshold.
Methods
We included 388,945 adult inpatients who tested positive for SARS-CoV-2 at 36 AP–HP (Assistance Publique–Hôpitaux de Paris) hospitals from 2 May 2020 to 2 November 2021. We compared the prevalence of antidepressant use at admission in a 1:1 ratio matched analytic sample with and without COVID-19 (N = 82,586), and assessed its association with 28-day all-cause mortality in a 1:1 ratio matched analytic sample of COVID-19 inpatients with and without antidepressant use at admission (N = 1482) (Figure 1).
Results
Antidepressant use was significantly less prevalent in inpatients with COVID-19 than in a matched control group of inpatients without COVID-19 (1.9% versus 4.8%; Odds Ratio (OR) = 0.38; 95%CI = 0.35–0.41, p < 0.001) (Figure 2). Antidepressant use was significantly associated with reduced 28-day mortality among COVID-19 inpatients (12.8% versus 21.2%; OR = 0.55; 95%CI = 0.41–0.72, p < 0.001), particularly at daily doses of at least 40 mg fluoxetine equivalents (Figure 3). Antidepressants with high FIASMA (Functional Inhibitors of Acid Sphingomyelinase) activity seem to drive both associations.
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Conclusions
Antidepressant use is associated with a reduced likelihood of hospitalization in patients infected with SARS-CoV-2 and with a reduced risk of death in patients hospitalized with COVID-19. These associations were stronger for molecules with high FIASMA activity. These findings posit that prospective interventional studies of antidepressants with the highest FIASMA activity may be appropriate to help identify variant-agnostic, affordable, and scalable interventions for outpatient and inpatient therapy of COVID-19.
Herbivore distribution throughout Africa is strongly linked to mean annual precipitation. We use that relationship to predict functional group composition of herbivore communities during the last glacial maximum (ca. 21 ka) on the now submerged Palaeo-Agulhas Plain (PAP), South Africa. We used metabolic large herbivore biomass (MLHB) from 39 South African protected areas, in five functional groups (characterized by behavior and physiology). We examined how modern factors influenced MLHB and considered the effects of biome, annual rainfall, percentage winter rainfall, and protected area size. Overall, biome was the most important factor influencing the relationship between MLHB and rainfall. In general, MLHB increased with rainfall, but not for the grassland biome. Outside grasslands, most functional groups’ metabolic biomass increased with increasing rainfall, irrespective of biome, except for medium-sized social mixed feeder species in savanna and thicket. Protected area size was influential for medium-sized social mixed feeders and large browsers and rainfall influenced medium-sized social mixed feeders, offering some perspectives on spatial constraints on past large herbivore biomass densities. These results improve our understanding of the likely herbivore community composition and relative biomass structure on the PAP, an essential driver of how early humans utilized large mammals as a food resource.
To develop a pediatric research agenda focused on pediatric healthcare-associated infections and antimicrobial stewardship topics that will yield the highest impact on child health.
Participants:
The study included 26 geographically diverse adult and pediatric infectious diseases clinicians with expertise in healthcare-associated infection prevention and/or antimicrobial stewardship (topic identification and ranking of priorities), as well as members of the Division of Healthcare Quality and Promotion at the Centers for Disease Control and Prevention (topic identification).
Methods:
Using a modified Delphi approach, expert recommendations were generated through an iterative process for identifying pediatric research priorities in healthcare associated infection prevention and antimicrobial stewardship. The multistep, 7-month process included a literature review, interactive teleconferences, web-based surveys, and 2 in-person meetings.
Results:
A final list of 12 high-priority research topics were generated in the 2 domains. High-priority healthcare-associated infection topics included judicious testing for Clostridioides difficile infection, chlorhexidine (CHG) bathing, measuring and preventing hospital-onset bloodstream infection rates, surgical site infection prevention, surveillance and prevention of multidrug resistant gram-negative rod infections. Antimicrobial stewardship topics included β-lactam allergy de-labeling, judicious use of perioperative antibiotics, intravenous to oral conversion of antimicrobial therapy, developing a patient-level “harm index” for antibiotic exposure, and benchmarking and or peer comparison of antibiotic use for common inpatient conditions.
Conclusions:
We identified 6 healthcare-associated infection topics and 6 antimicrobial stewardship topics as potentially high-impact targets for pediatric research.
In 1990, Latin American countries committed to psychiatric reforms including psychiatric bed removals. Aim of the study was to quantify changes in psychiatric bed numbers and prison population rates after the initiation of psychiatric reforms in Latin America.
Methods
We searched primary sources to collect numbers of psychiatric beds and prison population rates across Latin America between the years 1991 and 2017. Changes of psychiatric bed numbers were compared against trends of incarceration rates and tested for associations using fixed-effects regression of panel data. Economic variables were used as covariates. Reliable data were obtained from 17 Latin American countries: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Honduras, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru, El Salvador, Uruguay and Venezuela.
Results
The number of psychiatric beds decreased in 15 out of 17 Latin American countries (median −35%) since 1991. Our findings indicate the total removal of 69 415 psychiatric beds. The prison population increased in all countries (median +181%). Panel data regression analyses showed a significant inverse relationship −2.70 (95% CI −4.28 to −1.11; p = 0.002) indicating that prison populations increased more when and where more psychiatric beds were removed. This relationship held up when introducing per capita income and income inequality as covariates −2.37 (95% CI −3.95 to −0.8; p = 0.006).
Conclusions
Important numbers of psychiatric beds have been removed in Latin America. Removals of psychiatric beds were related to increasing incarceration rates. Minimum numbers of psychiatric beds need to be defined and addressed in national policies.
Depression is common in Alzheimer's disease (AD) with important clinical implications, but the etiology is not known.
Methods
30 subjects (15 with depression and 15 non-depressed matched for age, gender and cognitive impairment) with mild probable AD, defined as Mini-Mental State Examination score of 20 or above, diagnosed according to NINCDS-ADRDA criteria were included in the study. Data were collected at geriatric medicine and psychiatry outpatient clinics at three hospitals in Western Norway and all subjects underwent comprehensive clinical assessment. Montgomery-Asberg Depression Rating Scale with a cut-off point of 6/7 was used to evaluate depression. Automatic preprocessing using Freesurfer included steps for white and grey matter surface reconstruction. The resulting cortical thickness measurement was used in the subsequent GLM-based analysis. Correction for multiple comparisons was carried out cluster-wise by method of Monte Carlo.
Results
We found 3 clusters of significantly reduced cortical thickness in the depressed group. The first cluster (p = 0,0014) contained Left Frontal Pole and Lateral Orbitofrontal cortex. The second cluster (p = 0,0131) included Left Anterior Temporal Area; Right Medial Prefrontal, Anterior Cingulate, Subgenual Cingulate and Medial Orbitofrontal cortex were included in the third cluster (p = 0,0032).
Conclusion
Depression in AD is associated with reduced cortical thickness in prefrontal and anterior temporal cortices. These areas have been found to be associated with depression in other age-related disorders as well as in major depression. This convergence of morphological profiles suggests a possible unity of depression brain mechanisms across disorders.
Brightest cluster galaxies (BCGs) residing in cool-core clusters are known to be the stage of intricate baryon cycle phenomena (e.g. gas inflows, AGN outflows, star formation feedback). The scenarios describing the observed properties of these galaxies are still controversial, suffering from limitations due to the spatial resolving power of the instruments, specifically for galaxies beyond the Local Universe. However, the dramatic improvements introduced by the integral-field unit instruments (e.g. MUSE) could shed light on the physical processes driving the evolution of these galaxies. We present an extensive analysis of the stellar and gas properties (i.e. kinematics, stellar mass, star formation rate) of the radio-loud BCG sitting at the centre of the X-ray luminous cool-core cluster Abell 2667 (z = 0.23), based on MUSE data. Our results indicate that the BCG is a massive elliptical, hosting an AGN that is possibly undergoing accretion of cold star-forming clouds of ICM or galactic cannibalism.
Childhood adversity (CA) increases the risk of subsequent mental health problems. Adolescent social support (from family and/or friends) reduces the risk of mental health problems after CA. However, the mechanisms of this effect remain unclear, and we speculate that they are manifested on neurodevelopmental levels. Therefore, we investigated whether family and/or friendship support at ages 14 and 17 function as intermediate variables for the relationship between CA before age 11 and affective or neural responses to social rejection feedback at age 18. We studied 55 adolescents with normative mental health at age 18 (26 with CA and therefore considered “resilient”), from a longitudinal cohort. Participants underwent a Social Feedback Task in the magnetic resonance imaging scanner. Social rejection feedback activated the dorsal anterior cingulate cortex and the left anterior insula. CA did not predict affective or neural responses to social rejection at age 18. Yet, CA predicted better friendships at age 14 and age 18, when adolescents with and without CA had comparable mood levels. Thus, adolescents with CA and normative mood levels have more adolescent friendship support and seem to have normal mood and neural responses to social rejection.
Chemical weed control remains a widely used component of integrated weed management strategies because of its cost-effectiveness and rapid removal of crop pests. Additionally, dicamba-plus-glyphosate mixtures are a commonly recommended herbicide combination to combat herbicide resistance, specifically in recently commercially released dicamba-tolerant soybean and cotton. However, increased spray drift concerns and antagonistic interactions require that the application process be optimized to maximize biological efficacy while minimizing environmental contamination potential. Field research was conducted in 2016, 2017, and 2018 across three locations (Mississippi, Nebraska, and North Dakota) for a total of six site-years. The objectives were to characterize the efficacy of a range of droplet sizes [150 µm (Fine) to 900 µm (Ultra Coarse)] using a dicamba-plus-glyphosate mixture and to create novel weed management recommendations utilizing pulse-width modulation (PWM) sprayer technology. Results across pooled site-years indicated that a droplet size of 395 µm (Coarse) maximized weed mortality from a dicamba-plus-glyphosate mixture at 94 L ha–1. However, droplet size could be increased to 620 µm (Extremely Coarse) to maintain 90% of the maximum weed mortality while further mitigating particle drift potential. Although generalized droplet size recommendations could be created across site-years, optimum droplet sizes within each site-year varied considerably and may be dependent on weed species, geographic location, weather conditions, and herbicide resistance(s) present in the field. The precise, site-specific application of a dicamba-plus-glyphosate mixture using the results of this research will allow applicators to more effectively utilize PWM sprayers, reduce particle drift potential, maintain biological efficacy, and reduce the selection pressure for the evolution of herbicide-resistant weeds.
Accurate weed emergence models are valuable tools for scheduling planting, cultivation, and herbicide applications. Multiple models predicting giant ragweed emergence have been developed, but none have been validated in diverse crop rotation and tillage systems, which have the potential to influence weed emergence patterns. This study evaluated the performance of published giant ragweed emergence models across various crop rotations and spring tillage dates in southern Minnesota. Across experiments, the most robust model was a mixed-effects Weibull (flexible sigmoidal function) model predicting emergence in relation to hydrothermal time accumulation with a base temperature of 4.4 C, a base soil matric potential of −2.5 MPa, and two random effects determined by overwinter growing degree days (GDD) (10 C) and precipitation accumulated during seedling recruitment. The deviations in emergence between individual plots and the fixed-effects model were distinguished by the positive association between the lower horizontal asymptote (Drop) and maximum daily soil temperature during seedling recruitment. This finding indicates that crops and management practices that increase soil temperature will have a shorter lag phase at the start of giant ragweed emergence compared with practices promoting cool soil temperatures. Thus, crops with early-season crop canopies such as perennial crops and crops planted in early spring and in narrow rows will likely have a slower progression of giant ragweed emergence. This research provides a valuable assessment of published giant ragweed emergence models and illustrates that accurate emergence models can be used to time field operations and improve giant ragweed control across diverse cropping systems.
A multidecadal-scale lake-level reconstruction for Lago Wiñaymarca, the southern basin of Lake Titicaca, has been generated from diatom species abundance data. These data suggest that ~6500 cal yr BP Lago Wiñaymarca was dry, as indicated by a sediment unconformity. At ~4400 cal yr BP, the basin began to fill, as indicated by the dominance of shallow epiphytic species. It remained somewhat saline with extensive wetlands and abundant aquatic plants until ~3800 cal yr BP, when epiphytic species were replaced by planktic saline-indifferent species, suggesting a saline shallow lake. Wiñaymarca remained a relatively shallow lake that fluctuated on a multidecadal scale until ~1250 cal yr BP, when freshwater planktic species increased, suggesting a rise in lake level with a concomitant decrease in salinity. The lake became gradually fresher, dominated by deep, freshwater species from ~850 cal yr BP. By ~80 cal yr BP, saline-tolerant species were rare, and the lake was dominated by freshwater planktic diatoms, resembling the fresh and deep lake of today. These results reveal a more dynamic and chronologically specific record of lake-level fluctuations and associated ecological conditions that provide important new data for paleoclimatologists and archaeologists, to better understand human-environmental dynamics during the mid- to late Holocene.
Temperature variations over Europe are reconstructed for a 6-month “summer” season from April to September for the period 1750–1850 using a network of maximum latewood density chronologies of coniferous trees. Around 44% of the variance of the whole temperature grid was explained in calibration. Independent verification indicates that over the reconstruction period the explained variance averaged over the whole grid should lie in the range 30 to 35%. The reconstructions are better in the north of the region (about 50% explained temperature variance based on comparison with independent climate data) than in the south (below 20%). The temperature recontructions indicate cooler summers over Europe from 1812 to 1816 and during the 1830s. The summers of the 1820s were the warmest reconstructed. Decadal variations occur on a regional scale but no similar periods of anomalously cooler or warmer summers occurred between 1750 and 1810 throughout Europe.
The use of POST herbicides has been limited in sweet corn because of the narrow spectrum of weed control or potential crop injury. Field experiments were conducted to evaluate the 4-hydroxyphenyl pyruvate dioxygenase (HPPD)-inhibiting herbicides mesotrione, tembotrione, and topramezone applied POST in sweet corn at three locations. Efficacy of mesotrione, tembotrione, and topramezone applied alone or mixed with atrazine was compared to other labeled POST herbicides following PRE S-metolachlor. Giant foxtail control was greater with tembotrione or topramezone than mesotrione alone or mixed with atrazine. Common lambsquarters, velvetleaf, and common ragweed were controlled 98% or greater with the HPPD-inhibiting herbicides when mixed with atrazine. Tolerance of six sweet corn hybrids was determined in the field when treated with 1× and 2× rates of these herbicides mixed with atrazine. Tolerance of six sweet corn hybrids to these herbicides was determined in the greenhouse when treated with 0.5, 1, 2, 4, 8, and 16 times the labeled rate. Differential hybrid tolerance to each herbicide was observed in both the field and greenhouse evaluations. Tembotrione killed ‘Merit’ in both evaluations. Excluding Merit, hybrids generally had good tolerance to tembotrione and topramezone in the field, but had differential tolerance to mesotrione. With the exception of Merit, hybrids generally had greater tolerance to tembotrione than topramezone and less tolerance to mesotrione in the greenhouse. These HPPD-inhibiting herbicides provide POST weed control, but the potential for sweet corn injury varies among the herbicides and hybrids and warrants further characterization.
We investigated the effect of maternal sire on early pregnancy failure (between D0, day of insemination and D90) in their progeny during the first and second lactations (n=3508) in the Holstein breed. The estimated breeding value (EBV) for cow fertility of 12 bulls (reliability⩾0.95) was used to create the following three groups: low, medium and high EBV (EBV from −0.7 to 1 expressed as genetic standard deviation relative to the mean of the breed). In their daughters (93 to 516 per bull), progesterone measurement was carried out on the day of artificial insemination (AI; D0) to check whether the cows were in the follicular phase and on D18 to 25 to assess non-fertilisation-early embryonic mortality (NF-EEM). Late embryonic mortality (LEM) and early foetal death (FD) were determined by ultrasonography on D45 and D90 and by the return to oestrus after the first AI. Frequencies of NF-EEM, LEM, FD and pregnancy were 33.3%, 11.7%, 1.4% and 48.5% and incidences were 35.1, 19.0, 2.7 and 51.1, respectively. Sire EBV was significantly related to the incidences of pregnancy failure between D0 and D90, fertilisation failure-early embryonic mortality (FF-EEM) and LEM but not to the incidence of FD between D45 and D90 of pregnancy. The relative risk (RR) of FF-EEM was significantly higher (RR=1.2; P<0.05) for the progeny group of low EBV bulls when compared with high EBV bulls. The same effect was observed when comparing LEM of the progeny groups from the low EBV bulls to those from moderate and high EBV bulls (RR, respectively, of 1.3 and 1.4; P<005). The incidence of FF-EEM was significantly higher when cows were inseminated before 80 days postpartum compared with later, and for the extreme values of the difference between milk fat and protein content measured during the first 3 months of lactation. FF-EEM was also significantly related to the year of observation. The incidence of LEM was higher for the highest producing cows and was influenced by interaction between milk yield×lactation rank and milk yield×milk protein content. In conclusion, this study showed large differences in early pregnancy failure between progeny groups and highlights the interest of accurate characterisation of embryonic death in order to identify potential candidate genes for female fertility.